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Most California kids with mental health problems are untreated

More than 300,000 California kids between the ages 4 and 11 need mental healthcare, but only one in four is treated
More than 300,000 California kids between the ages 4 and 11 need mental healthcare, but only one in four is treated
Robin Wulffson, MD

A report released the UCLA Center for Health Policy Research on July 28 found that three out of four California kids do not receive treatment for mental health problems. The center noted that, the Centers for Disease Control and Prevention (CDC) recommends early-childhood intervention as a critical step in reducing the severity of mental health problems in adulthood. Sadly, however, more than 300,000 California kids between the ages 4 and 11 need mental healthcare, but only one in four is treated.

The researchers used California Health Interview Survey (CHIS) data from 2007–2009. “Without early assessment, you miss warning signs, as well as opportunities to intervene,” noted lead author Imelda Padilla-Frausto, a researcher at the center. She added, “Waiting can lead to more serious problems later.” Approximately8.5% of all California children in the 4-to-11 age group are identified as having mental healthcare issues, including conduct problems, emotional symptoms, hyperactivity and problems with peers; however, parents reported that 70.8% of these children went without emotional or psychological counseling over the previous year.

The study examined a number of factors that contribute to mental health needs among children as well as obstacles that may contribute to a lack of treatment. The researchers found that being in poor health or asthmatic, which precludes participation in physical activities with other children, significantly increased the likelihood of a child having mental health problems. Other factors that contributed to mental health issues were having a parent with mental health or a physical disability, living in a single-parent household, or poverty.

Among the contributing factors, poor health had the strongest correlation to mental health needs. One in five children in poor health (22.4%) had mental health issues, compared with 6.9% of children in excellent or good health. Children who had a parent with mental health issues had three times the likelihood of having similar needs (20.5%), compared with 7.7 percent of children who did not have a parent with mental health needs. Furthermore, boys had a higher prevalence of mental health needs than girls (11% vs. 6%).

The problem was not do to lack of health insurance; 95% of children in need of mental healthcare had health insurance and saw a doctor regularly; however, they did not receive mental healthcare. The authors noted that this finding suggested that their parents may face many barriers to obtaining such treatment. A previous study found that a shortage of mental health professionals was one barrier to treatment, and the complexities involved in navigating the mental healthcare system was cited as another.

Another issue was language. The study found that a lack of healthcare professionals who speak more than one language impacted treatment; 66.5% of children in need who had English-proficient parents went without treatment, compared with 88.6% of children whose parents had limited English skills. The authors noted that social stigma surrounding mental healthcare treatment may also be a factor.

The authors noted that because of the links between physical health and mental health, identifying and treating a child should start with an exam by a physician and include a mental health screening. They recommended that the resulting information should be shared among physicians, medical groups, and mental health professionals. They noted that, beyond identifying, treating, and tracking the mental healthcare needs of an individual child, healthcare professionals should also recognize that the child’s entire family might be at risk and require mental health outreach, translators, and other types of assistance. In conclusion, they recommended that various government agencies and service providers, including healthcare professionals, child development groups, schools, housing agencies, and the juvenile justice system, need to combine forces to ensure healthy environments for children.

The complete report can be viewed at this link.

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